Day 2

Day 2 has gone pretty well thus far.  I have not had any major side effects.  A little constipation.  The prednisone makes me jittery.  Three more days of that for this round.

For some background information:  The cancer cell(s) began in a lymph node.  Maybe in the cervical or inguinal area (those are the places that showed up on the PETCT for nodes).  It then migrated to bones in the face, the arms, and the legs.  I assume the marrow.  It then moved into the cortical bone in the proximal (upper) right Tibia (the big bone in the lower leg) and caused a fracture there.  Didn't show up on a regular x-ray or CT.  Only on the PETCT.  

For a PET scan, they give you some glucose marked with a radioactive substance.  It is called FDG. The F is a radioactive substance.  It is radioactive fluorine replacing an O or OH.  One of our more chemical people can give us the answer.  The FDG is picked up by cells with a high metabolic rate--like those undergoing rapid cell division (cancer cells).  The body had been started for glucose overnight.  The F has a short half-life and disappears from the body quickly.  I don't glow in the dark!

FDG

A nice quick video

I don't have my image but these were the results in medical speak.

1. Intensely FDG avid nodal lymphoma in the bilateral neck and right inguinal region. (lymph nodes, must have started in one of these)
2. Intense FDG uptake throughout the maxillofacial structures, as detailed above, is highly suspicious for extranodal lymphoma. (in the face, I do feel some pressure, and my teeth sometimes ache a bit)
3. Multifocal intensely FDG avid osseous lymphoma involving the maxillofacial region and bilateral upper and lower extremities, with the greatest volume of disease centered around the knees and elbows. There is a pathologic intra-articular fracture associated with a dominant lytic lesion in the medial right tibial plateau. (right knee can stand very little weight, hurts like crazy, hence the wheelchair)
4. Intense asymmetric FDG uptake in the left hamstring tendon is favored inflammatory.  (Interesting, I have no pain there)

A scan might look like this.  The darker the red, the greater the uptake of FDG.  Big tumor on this one.